WEDNESDAY, May 7, 2003 (HealthDayNews) -- Doctors treating Lyme disease often prescribe antibiotics for more than twice as long as necessary, a new study claims.
Taking the antibiotic doxycycline for 10 days proved just as effective as a 20-day course for treatment of the tick-borne disease in its early stages when a rash first appears, according to research in the May 6 issue of the Annals of Internal Medicine.
Most doctors prescribe 21 days of doxycycline for early Lyme disease, and that, says lead researcher Dr. Gary P. Wormser, is unnecessary overkill.
"Sometimes, less is more," says Wormser, chief of infectious diseases at New York Medical College and Westchester Medical Center.
For early Lyme disease, he says, "our study showed pretty well that the duration of antibiotic therapy doesn't have to be as long as people thought."
Shorter courses are equally effective, safer, less expensive and less likely to promote bacterial resistance to antibiotics, Wormser says.
Wormser and his fellow researchers focused on 180 people with early Lyme disease and divided the patients into three groups.
One group received doxycycline for 20 days, while a second got 10 days of the antibiotic. A third group got one intravenous dose of another antibiotic, ceftriaxone, and 10 days of doxycycline.
After 20 days, about two-thirds of the patients in all three groups had complete recovery from Lyme disease, and more than 80 percent fully recovered after 30 months. Researchers found no significant difference in responses among the three groups.
The study also found patients who had a single dose of ceftriaxone had significantly more diarrhea.
One patient who received 10 days of doxycycline had Lyme meningitis, which responded to two weeks' treatment with intravenous ceftriaxone, the researchers say.
Length of Lyme disease treatment with antibiotics has been growing longer in recent years, Wormser says, despite a lack of evidence showing longer treatment is necessary or beneficial.
Last year, a record 18,000 cases of Lyme disease, caused by being bitten by an infected deer tick, were reported to the U.S. Centers for Disease Control and Prevention.
Lyme disease is an acute inflammatory disease characterized by a skin rash, joint inflammation and flu-like symptoms. If untreated, it can lead to serious illness, such as painful arthritis or neurological problems.
Treating Lyme disease with antibiotics for a longer period than necessary is particularly worrisome because of the risk of strains of bacteria building resistance, Wormser says.
"Shorter courses of treatment may be less likely to promote the emergence of resistant bacteria that can endanger the entire community," he says. "In this day and age, any unnecessary use of antibiotics in the community or hospital setting is to be avoided. That's a big deal."
David L. Weld, executive director of the American Lyme Disease Foundation, says he agrees that a 10-day course of antibiotic treatment should be enough for most people with early stages of the disease.
But Weld adds that different patients get symptoms at different times, and it's hard to make generalizations about the course of treatment necessary.
"One question that always comes to mind is: Where is the dividing line?" he says. "A lot of science is blurry. Unfortunately, everybody develops different symptoms at different times."